Modified Nesbit Procedure: An Easy and Effective Technique

Abstract

This paper reports the results of a modified Nesbit procedure, designed to increase precision and to simplify the correction of penile congenital or acquired curvatures. Materials and Methods 58 patients in total were considered candidates for surgical treatment of penile curvature, and underwent a modified corporoplasty procedure involving plication suture on the convex aspect of the penis before tunica albuginea resection. Hospital records and follow-up data were retrospectively reviewed. Results 37 patients were affected by congenital penile curvature (mean angle: 48 degrees - range 40 to 90); they reported difficult vaginal penetration. Another 21 patients suffered from Peyronie's disease, with mean angle penile deformity of 48 degrees (range 40 to 60), but no hourglass deformity or hinge effects. All patients had spontaneous and full erections. Mean operative time ±SD was 62±15 minutes. No intra-operative complications were reported. Penile curvature was completely corrected in all cases. Neither residual curvatures nor hypercorrections were recorded. Regarding erectile function, which was evaluated in the Peyronie's disease group, pre-operative average International Index of Erectile Function-5 score was 17.83±4.17, whereas post-operatively it was 19±4.63 (p >0.036). With regard to overall satisfaction, 3 patients (5%) with Peyronie's disease were unsatisfied. Conclusions This modified corporoplasty procedure has resulted in an improved straightening outcome thanks to the possibility of performing tunica albuginea excision only after the surgeon has made and verified the exact correction in real time. A slight but statistically significant improvement in erectile function was observed in patients with Peyronie's disease.